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- Abdellah, Tebani, et al.
(författare)
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Integration of molecular profiles in a longitudinal wellness profiling cohort.
- 2020
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Ingår i: Nature communications. - : Springer Science and Business Media LLC. - 2041-1723. ; 11:1
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Tidskriftsartikel (refereegranskat)abstract
- An important aspect of precision medicine is to probe the stability in molecular profiles among healthy individuals over time. Here, we sample a longitudinal wellness cohort with 100 healthy individuals and analyze blood molecular profiles including proteomics, transcriptomics, lipidomics, metabolomics, autoantibodies andimmune cell profiling, complementedwith gut microbiota composition and routine clinical chemistry. Overall, our results show high variation between individuals across different molecular readouts, while the intra-individual baseline variation is low. The analyses show that each individual has a unique and stable plasma protein profile throughout the study period and that many individuals also show distinct profiles with regards to the other omics datasets, with strong underlying connections between the blood proteome and the clinical chemistry parameters. In conclusion, the results support an individual-based definition of health and show that comprehensive omics profiling in a longitudinal manner is a path forward for precision medicine.
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| 3. |
- Andersson, Jonas, 1975-, et al.
(författare)
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Estimation of patient skin dose in fluoroscopy : summary of a joint report by AAPM TG357 and EFOMP
- 2021
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Ingår i: Medical physics (Lancaster). - : John Wiley & Sons. - 0094-2405 .- 2473-4209. ; 48:7, s. e671-e696
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Tidskriftsartikel (refereegranskat)abstract
- Background: Physicians use fixed C-arm fluoroscopy equipment with many interventional radiological and cardiological procedures. The associated effective dose to a patient is generally considered low risk, as the benefit-risk ratio is almost certainly highly favorable. However, X-ray-induced skin injuries may occur due to high absorbed patient skin doses from complex fluoroscopically guided interventions (FGI). Suitable action levels for patient-specific follow-up could improve the clinical practice. There is a need for a refined metric regarding follow-up of X-ray-induced patient injuries and the knowledge gap regarding skin dose-related patient information from fluoroscopy devices must be filled. The most useful metric to indicate a risk of erythema, epilation or greater skin injury that also includes actionable information is the peak skin dose, that is, the largest dose to a region of skin.Materials and Methods: The report is based on a comprehensive review of best practices and methods to estimate peak skin dose found in the scientific literature and situates the importance of the Digital Imaging and Communication in Medicine (DICOM) standard detailing pertinent information contained in the Radiation Dose Structured Report (RDSR) and DICOM image headers for FGI devices. Furthermore, the expertise of the task group members and consultants have been used to bridge and discuss different methods and associated available DICOM information for peak skin dose estimation.Results: The report contributes an extensive summary and discussion of the current state of the art in estimating peak skin dose with FGI procedures with regard to methodology and DICOM information. Improvements in skin dose estimation efforts with more refined DICOM information are suggested and discussed.Conclusions: The endeavor of skin dose estimation is greatly aided by the continuing efforts of the scientific medical physics community, the numerous technology enhancements, the dose-controlling features provided by the FGI device manufacturers, and the emergence and greater availability of the DICOM RDSR. Refined and new dosimetry systems continue to evolve and form the infrastructure for further improvements in accuracy. Dose-related content and information systems capable of handling big data are emerging for patient dose monitoring and quality assurance tools for large-scale multihospital enterprises.
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| 4. |
- Berry, Max, 1969, et al.
(författare)
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Endovascular training with animals versus virtual reality systems: an economic analysis
- 2008
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Ingår i: J Vasc Interv Radiol. - : Elsevier BV. - 1051-0443. ; 19:2 Pt 1, s. 233-8
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To assess the relative costs of a virtual reality (VR) laboratory and an animal laboratory for endovascular skills training. MATERIALS AND METHODS: Cost data extracted from a previous experiment was used to perform a financial analysis according to the guidelines published by the National Institutes of Health. The analysis compared the purchase or rental of a Procedicus Vascular Interventional System Trainer to the rental of an animal laboratory. RESULTS: The VR laboratory course cost $3,434 per trainee versus $4,634 in the animal laboratory according to the purchase-versus-rental analysis. The cost ratio was 0.74 in favor of the VR laboratory. Cost ratio sensitivity analysis ranged from 0.25 in favor of the VR laboratory to 2.22 in favor of the animal laboratory. The first-year potential savings were $62,410 assuming exclusive use of the VR laboratory. The 5-year training savings totaled $390,376, excluding the $60,000 residual value of the simulator. Simulator rental reduced the course price to $1,076 per trainee and lowered the cost ratio to 0.23 in favor of the VR laboratory. Findings of sensitivity analysis ranged from 0.08 to 0.70 in favor of the VR laboratory. The first-year and 5-year potential national savings increased to $185,026 and $1,013,238, respectively. CONCLUSIONS: Although evidence remains sparse that the training of interventional skills in artificial environments translates to better performance in human procedures, there are good pedagogic grounds on which to believe that such training will become increasingly important. The present comparison of the direct costs of two such models suggests that VR training is less expensive than live animal training.
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| 5. |
- Havervall, Sebastian, et al.
(författare)
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Antibody responses after a single dose of ChAdOx1 nCoV-19 vaccine in healthcare workers previously infected with SARS-CoV-2
- 2021
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Ingår i: EBioMedicine. - : Elsevier BV. - 2352-3964. ; 70
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Tidskriftsartikel (refereegranskat)abstract
- Background: Recent reports demonstrate robust serological responses to a single dose of messenger RNA (mRNA) vaccines in individuals previously infected with SARS-CoV-2. Data on immune responses following a single-dose adenovirus-vectored vaccine expressing the SARS-CoV-2 spike protein (ChAdOx1 nCoV-19) in individuals with previous SARS-CoV-2 infection are however limited, and current guidelines recommend a two-dose regimen regardless of preexisting immunity. Methods: We compared RBD-specific IgG and RBD-ACE2 blocking antibodies against SARS-CoV-2 wild type and variants of concern following two doses of the mRNA vaccine BNT162b2 in SARS-CoV-2 naive healthcare workers (n=65) and a single dose of the adenovector vaccine ChAdOx1 nCoV-19 in 82 healthcare workers more than (n=45) and less than (n=37) 11 months post mild SARS-CoV-2 infection at time of vaccination. Findings: The post-vaccine levels of RBD-specific IgG and neutralizing antibodies against the SARS-CoV-2 wild type and variants of concern including Delta lineage 1.617.2 were similar or higher in participants receiving a single dose of ChAdOx1 nCoV-19 vaccine post SARS-CoV-2 infection (both more than and less than 11 months post infection) compared to SARS-CoV-2 naive participants who received two doses of BNT162b2 vaccine. Interpretation: Our data support that a single dose ChAdOx1 nCoV-19 vaccine that is administered up to at least 11 months post SARS-CoV-2 infection serves as an effective immune booster. This provides a possible rationale for a single-dose vaccine regimen. (C) 2021 The Author(s). Published by Elsevier B.V.
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| 6. |
- Hellström, Max, et al.
(författare)
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Denoising and uncertainty estimation in parameter mapping with approximate Bayesian deep image priors
- 2023
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Ingår i: Magnetic Resonance in Medicine. - : John Wiley & Sons. - 0740-3194 .- 1522-2594. ; 90:6, s. 2557-2571
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To mitigate the problem of noisy parameter maps with high uncertainties by casting parameter mapping as a denoising task based on Deep Image Priors.Methods: We extend the concept of denoising with Deep Image Prior (DIP) into parameter mapping by treating the output of an image-generating network as a parametrization of tissue parameter maps. The method implicitly denoises the parameter mapping process by filtering low-level image features with an untrained convolutional neural network (CNN). Our implementation includes uncertainty estimation from Bernoulli approximate variational inference, implemented with MC dropout, which provides model uncertainty in each voxel of the denoised parameter maps. The method is modular, so the specifics of different applications (e.g., T1 mapping) separate into application-specific signal equation blocks. We evaluate the method on variable flip angle T1 mapping, multi-echo T2 mapping, and apparent diffusion coefficient mapping.Results: We found that deep image prior adapts successfully to several applications in parameter mapping. In all evaluations, the method produces noise-reduced parameter maps with decreased uncertainty compared to conventional methods. The downsides of the proposed method are the long computational time and the introduction of some bias from the denoising prior.Conclusion: DIP successfully denoise the parameter mapping process and applies to several applications with limited hyperparameter tuning. Further, it is easy to implement since DIP methods do not use network training data. Although time-consuming, uncertainty information from MC dropout makes the method more robust and provides useful information when properly calibrated.
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| 8. |
- Löfstedt, Tommy, et al.
(författare)
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Bayesian non-linear regression with spatial priors for noise reduction and error estimation in quantitative MRI with an application in T1 estimation
- 2020
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Ingår i: Physics in Medicine and Biology. - : Institute of Physics (IOP). - 0031-9155 .- 1361-6560. ; 65:22
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Tidskriftsartikel (refereegranskat)abstract
- Purpose. To develop a method that can reduce and estimate uncertainty in quantitative MR parameter maps without the need for hand-tuning of any hyperparameters.Methods. We present an estimation method where uncertainties are reduced by incorporating information on spatial correlations between neighbouring voxels. The method is based on a Bayesian hierarchical non-linear regression model, where the parameters of interest are sampled, using Markov chain Monte Carlo (MCMC), from a high-dimensional posterior distribution with a spatial prior. The degree to which the prior affects the model is determined by an automatic hyperparameter search using an information criterion and is, therefore, free from manual user-dependent tuning. The samples obtained further provide a convenient means to obtain uncertainties in both voxels and regions. The developed method was evaluated on T1 estimations based on the variable flip angle method.Results. The proposed method delivers noise-reduced T1 parameter maps with associated error estimates by combining MCMC sampling, the widely applicable information criterion, and total variation-based denoising. The proposed method results in an overall decrease in estimation error when compared to conventional voxel-wise maximum likelihood estimation. However, this comes with an increased bias in some regions, predominately at tissue interfaces, as well as an increase in computational time.Conclusions. This study provides a method that generates more precise estimates compared to the conventional method, without incorporating user subjectivity, and with the added benefit of uncertainty estimation.
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- Najm, Svetlana, et al.
(författare)
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Effects of a lipid emulsion containing fish oil on polyunsaturated fatty acid profiles, growth and morbidities in extremely premature infants: A randomized controlled trial
- 2017
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Ingår i: Clinical Nutrition ESPEN. - : Elsevier BV. - 2405-4577. ; 20, s. 17-23
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Tidskriftsartikel (refereegranskat)abstract
- © 2017 The Authors Background & aims The purpose of the study was to compare the effects of the parenteral emulsion SMOFlipid ® , with 15% fish oil, with Clinoleic ® on retinopathy of prematurity (ROP) and other morbidities and growth, and to compare their impact on longitudinal serum levels of fatty acids. Retinopathy of prematurity, other morbidity and growth were correlated with each parenteral lipid supplement. Methods Ninety infants born at gestational age < 28 weeks were randomized to treatment with SMOFlipid ® or Clinoleic ® . Two thirds (66%) of the infants received parenteral nutrition for up to 14 days birth (median 8, range 2–14 days), and additional 25% of the infants received for up to 28 days after birth (median 21, range 15–28 days). Cord blood samples and then venous blood samples were obtained at ages 1, 7, 14, and 28 days and at postmenstrual age (PMA) 32, 36, and 40 weeks. Breastmilk was collected at postnatal day 7, and at PMA 32 and 40 weeks. Serum phospholipid and breastmilk total fatty acids were analyzed by gas chromatography–mass spectrometry. Treatment groups were compared with regard to ROP, bronchopulmonary dysplasia, necrotizing enterocolitis, patent ductus arteriosus sepsis and growth between birth and 36 weeks. Results Infants on SMOFlipid ® had higher fractions of omega-3 LCPUFA eicosapentaenoic acid (EPA) and slightly higher omega-3 LCPUFA docosahexaenoic acid (DHA) fraction and a decreased arachidonic acid (AA) to DHA ratio from one week after birth up to 32 postmenstrual weeks compared to infants on Clinoleic ® . Treatment groups did not differ in morbidities or growth. Conclusion Supplementation with SMOFlipid ® containing 15% fish oil during parenteral nutrition increased EPA substantially, DHA marginally, reduced AA and decreased AA to DHA ratio. It did not reduce morbidity or affect growth. Since extremely preterm infants accumulate a large deficit of DHA and AA, studies on more prolonged or different levels of DHA and AA supplementation are warranted.
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